What you need to know about the coronavirus rebound | Johns Hopkins

What was originally called “paxthrobid rebound” (recurrence of coronavirus symptoms or a positive test after starting antiviral medication) can occur regardless of whether or not people are taking antiviral medication. Because of the potential for rebound, it is now more accurately referred to as a “COVID-19 rebound.”

Moreover, This is probably not a phenomenon unique to the new coronavirus. virologist Andy PecosPh.D., Professor Molecular microbiology and immunology.what teeth Unique to the new coronavirus are technologies that can track the progression of the infection very closely, particularly rapid antigen tests.

Researchers are continuing to investigate why some people experience a rebound from the coronavirus, whether people are contagious during this time, and the role that antiviral drugs like paxlobid may play.But one thing is certain, he says. Amesh Adaljamedical doctor, senior scholar of Johns Hopkins Health Safety Center Infectious disease and pandemic preparedness professionals: If you are at high risk for severe disease, the possibility of experiencing mild rebound symptoms should not deter you from taking paxlobid.

What is COVID-19 rebound?

COVID-19 rebound is “typically described as the return of signs and symptoms after initial recovery from COVID-19, or as a new positive test result for the virus.” According to the CDC. Generally, the order of events is as follows: A person is infected with the new coronavirus and has symptoms. The symptoms subsided during the course of the infection, and a home antigen test tested negative for the new coronavirus. Your symptoms may return and your home antigen test may come back positive.

One report found that rebound symptoms are generally mild, and no hospitalizations or deaths have occurred due to rebound. December 2023 CDC Report.

Why do some people experience a COVID-19 rebound?

Researchers are still working to understand why rebound occurs and how it differs from person to person. Some people experience a recurrence of symptoms, while others only see evidence with an antigen test. But at a molecular level, the fact that rebound occurs is not surprising, says Andy Pekosch.

“We think of infectious diseases as starting from nothing, reaching a peak, and then going away, but the human body is actually much more complex than that,” he says. Using more sensitive tools, virologists have determined that the amount of virus present in people infected with the coronavirus increases and decreases over the course of the infection, causing varying degrees of symptoms.

Does Paxrobid cause rebound symptoms?

CDC review of coronavirus rebound research It was found that there was “no consistent association between treatment and rebound.” Paxlovid is directly cause Symptoms recur.In fact, only about 1 in 5 people who take paxlobid experience a reboundand many of them are asymptomatic.

“Paxlobid is taken daily for five days, during which time the immune response may be somewhat blunted. The hypothesis is that after those five days, the drug pressure from Paxlobid wears off and any remaining viral remnants are removed. This means that the symptoms may return,” Adalja said. “We don't really understand why it happens in some people and not others, but we think it may be related to subtle differences in the immune response and how it is affected by antiviral drugs. You may have.”

Risk of rebound People with high-risk or severe disease should not be prevented from taking paxlobid, and that should not prevent doctors from prescribing it. “Taking paxlobid clearly reduces the chance of developing severe COVID-19, regardless of COVID-19 rebound,” Pekos emphasizes.

Is it possible for people who don't take paxlobid to experience a rebound of the coronavirus?

yes. Pekos and other virologists conducted research in the fall of 2020 and spring 2021, before paxlobid was available. How do infectivity and viral load vary from person to person? In the course of COVID-19. Their results showed that Numerous examples of what we are now calling COVID-19 rebound: Recurrence of symptoms or positive antigen test.

According to Pekos, these results were not unexpected. “Many of our virologists were thinking: [rebound] “This has happened because we understand that these viruses come and go and your response is not a smooth curve,” he says.

Are people with rebound symptoms contagious?

Possibly, but Adalja explains that contagiousness is determined by a positive test rather than symptoms. “If you have rebound symptoms but don't get a positive result on a home antigen test, it's likely that you're not shedding enough virus to be infectious,” he says. “However, if you get a positive result on a home antigen test, it is likely correlated with contagiousness.”

If a home antigen test results in a positive result, does the density of the test line correlate with contagiousness?

Even if there is a faint line on a home antigen test, the test result is positive. “The test is being validated to say yes or no as to whether it detects viral material, not how contagious it is,” Pekosz explained. “A darker line means a higher viral load,” he says, but there is no system to correlate different shades of red with levels of infectivity.

“If you test positive after a previous negative test or after taking all doses of Paxlobid, masking and distancing are important,” Pekos says. “But again, that's only in the late stages of the infection, when you're feeling better and your symptoms aren't severe.”

Does rebound occur with other viruses such as influenza and RSV?

Rebound is also likely to occur with other viral infections, Pekosz said. “It probably happens with the flu, but we don't have a home test to figure it out,” Pekos said, adding that the availability of home flu tests in the future could help virologists determine if it's the case for the new coronavirus. He added that he hopes to be able to analyze influenza cases in the same way.

“What we can do in terms of diagnosing COVID-19 and tracking the course of the disease is light years ahead of what we can do for influenza,” Pekos says. “This is a testament to the fact that we've done good science and put tools in place to see the kinds of mutations that we've never seen in other viruses or infectious diseases.”

Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health.

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